Screening first-degree relatives of patients with bicuspid aortic valves cost-effective
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A strategy of screening first-degree relatives of patients with bicuspid aortic valves was cost-effective and cost-saving, researchers reported at the European Society of Cardiology Congress.
Because bicuspid aortic valves may lead to life-threatening conditions, early identification is clinically important. A team of researchers aimed to determine to what extent a cascade echocardiography screening program to identify early any first-degree relatives of patients with bicuspid aortic valves who also have bicuspid aortic valves was cost-effective, Idit Tessler, MD, MPH, from Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, said during a presentation. The findings were simultaneously published in European Heart Journal Quality Care & Clinical Outcomes.
“The prevalence of bicuspid aortic valves is estimated to be 10-fold higher in first-degree relatives,” Tessler said. “Cascade screening refers to the first-degree relatives of a bicuspid aortic valve index case, and is intended to facilitate early detection of bicuspid aortic valves and enhance prevention of complications.”
Tessler and colleagues constructed a decision analytic model with a state transition Markov model to estimate differences in costs and health benefits if first-degree relatives of patients with bicuspid aortic valves were screened or not screened.
In the base case analysis, compared with no screening, screening resulted in a gain of 0.3 quality-adjusted life-years and a lifelong cost savings of 644, making it a dominant strategy over not screening, the researchers reported.
In a one-way sensitivity analysis, screening was cost-effective across all cost, utility and probability variables that were examined, Tessler and colleagues found.
The results were consistent across an age range of 2 to 80 years, but cost-effectiveness declined slightly with advancing age.
In a probabilistic sensitivity analysis, 84% of scenarios were cost-effective and 70% of scenarios were cost-saving, while in an analysis using a willingness-to-pay threshold of $50,000, 83% of scenarios remained cost-effective, Tessler and colleagues found.
“This evaluation revealed that echocardiography screening of first-degree relatives of BAV index cases is not only clinically important, but also cost-effective and cost-saving,” Tessler said.
Reference:
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Tessler I, et al. Public Health and Health Economics ePosters. Presented at: European Society of Cardiology Congress; Aug. 27-30, 2021 (virtual meeting).
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